A widely accepted framework governs biomedical research and the practice of medicine in the civilian sector, but no such framework exists to guide the military in how it should treat its own personnel. Civilian bioethical principles are unsuitable because of fundamental differences between civilian and military core values. This paper proposes a framework for military bioethics. It begins by describing core military values, articulating how they differ from civilian goals and values, and explaining how these differences limit the ability of (...) civilian bioethical principles to govern military biomedicine. The paper then puts forward a set of more appropriate principles for the military and discusses how these principles apply in three main areas of controversy within military bioethics: the use of military personnel as research subjects; the deployment use of biomedical agents; and the obligations of military physicians toward their own troops. (shrink)

This paper investigates agents’ blameworthiness when they are part of a group that does harm. We analyse three factors that affect the scope of an agent’s blameworthiness in these cases: shared intentionality, interpersonal influence, and common knowledge. Each factor involves circumstantial luck. The more each factor is present, the greater is the scope of each agent’s vicarious blameworthiness for the other agents’ contributions to the harm. We then consider an agent’s degree of blameworthiness, as distinct from her scope of blameworthiness. (...) We suggest that an agent mostly controls her degree of blameworthiness—but even here, luck constrains what possible degrees of blameworthiness are open to her. (shrink)

During the COVID-19 pandemic people were increasingly obliged to wear facial masks and to reduce the number of people they met in person. In this study, we asked how these changes in social interactions are associated with young children's emotional development, specifically their emotion recognition via the labeling of emotions. Preschoolers labeled emotional facial expressions of adults and children in fully visible faces. In addition, we assessed children's COVID-19-related experiences and recorded children's gaze behavior during emotion labeling. We compared different (...) samples of preschoolers : The data for the no-COVID-19-experience sample were taken from studies conducted before the pandemic. The data for the with-COVID-19-experience sample were collected during the COVID-19 pandemic in Switzerland between June and November 2021. The results did not indicate differences in children's labeling behavior between the two samples except for fearful adult faces. Children with COVID-19-experience more often labeled fearful faces correctly compared to children with no COVID-19 experience. Furthermore, we found no relations between children's labeling behavior, their individual COVID-19-related experiences, and their gaze behavior. These results suggest that, even though the children had experienced differences in the amount and variability of facial input due to the pandemic, they still received enough input from visible faces to be able to recognize and label different emotions. (shrink)

Why do some global health initiatives receive priority from international and national political leaders while others receive minimal attention? We propose a framework for analyzing this question consisting of four categories of factors: the strength of the actors involved in the initiative, the power of the ideas they use to frame the issue, the nature of the political contexts in which they operate, and characteristics of the issue itself.We apply this framework to the case of a global initiative to reduce (...) maternal mortality, launched in 1987. Using a process-tracing methodology commonly employed in qualitative research, we conducted archival research and interviewed actors involved in the initiative. We find that despite two decades of effort the initiative remains in an early phase of development, hampered by difficulties in all these categories. However, the initiative's twentieth anniversary year, 2007, presents opportunities to build political momentum. To generate political priority advocates will need to address several challenges, including the creation of effective institutions to guide the initiative and the development of a public positioning of the issue that convinces political leaders to act.We draw on the framework and case study to suggest areas for future research on the determinants of political priority for global health initiatives, a subject that has attracted much speculation but little scholarship. (shrink)

A speaker's manner of delivery of an utterance can affect a listener's pragmatic interpretation of the message. Disfluencies influence a listener's off-line assessment of whether the speaker is truthful or deceptive. Do listeners also form this assessment during the moment-by-moment processing of the linguistic message? Here we present two experiments that examined listeners’ judgments of whether a speaker was indicating the true location of the prize in a game during fluent and disfluent utterances. Participants’ eye and mouse movements were biased (...) toward the location named by the speaker during fluent utterances, whereas the opposite bias was observed during disfluent utterances. This difference emerged rapidly after the onset of the critical noun. Participants were similarly sensitive to disfluencies at the start of the utterance and in the middle. Our findings support recent research showing that listeners integrate pragmatic information alongside semantic content during the earliest moments of language processing. Unlike prior work which has focused on pragmatic effects in the interpretation of the literal message, here we highlight disfluency's role in guiding a listener to an alternative non-literal message. (shrink)

This content analysis examines the ways that genocide is included in the high school world history content standards of eleven states with legislative mandates requiring genocide education, as well as if the content standards in those states differ from those of states without mandated genocide education. The null curriculum theorizes that the content that is not taught may be as important as what is taught; this lens allows for a nuanced analysis of the ways that genocide is included and excluded (...) in state standards. The findings suggest that states with legislative mandates requiring genocide education do not necessarily have high school world history content standards that require genocide education. The content standards in states with legislative mandates often omit acts of genocide, refrain from using the term “genocide,” and frame genocides as less important than the Holocaust, perpetuating the null curriculum of genocides. (shrink)

This article looks at the current state of sacred prostitution studies in both ancient Near Eastern and Classical Studies through the review of two books published in 2019. Both books reveal that the current trend is to dismiss the existence of sacred prostitution in antiquity, one by attempting (not entirely successfully) to agree with that assessment, and one by condemning that dismissal altogether. All things considered, it does now appear that there has been a marked change of opinion in the (...) academy, and that Aphrodite’s and Ištar’s cult brothels are making their way to the dustpan of historiography. (shrink)

The world of work is being changed at an unprecedented rate as a result of the rise of the Fourth Industrial Revolution. This rate of change was accelerated by the COVID-19 pandemic, which left organizations and their leadership to deal with myriad of challenges. These changes also impacted leaders’ identities in their work and their roles in their organizations. We examine how leaders responded to the various workplace challenges presented by the COVID-19 pandemic and what this meant for their work (...) identities as leaders. To do this, we made use of role identity theory, social identity theory, and leader identity. A qualitative study was conducted with a group of eight senior leaders from various South African and global organizations who had between five and 10 years’ work experience, and some had even more. Data were collected through semi-structured interviews, conducted virtually and in person. Thematic analysis was used to analyze the data. The main finding that emerged from the research was that leaders employed virtual leadership to ensure that customers’ expectations were met, and to manage team-and organizational performance. These leaders achieved this by fostering a digital culture and building effective teams. They achieved their leadership goals by ensuring social identity continuity amongst their teams. This required them taking on extra roles, such as strategist, technology expert, entrepreneur, coach, mentor, and member of the team. Their leader role identity, as part of their work identity, was amplified by the pandemic. The implication is that organizations should develop leadership development programs to increase and strengthen leader identities to capacitate them for times of crisis. (shrink)

Although some regulatory frameworks for the occupational health and safety of nanotechnology workers have been developed, worker safety and health issues in these laboratory environments have received less attention than many other areas of nanotechnology regulation. In addition, workers in nanotechnology labs are likely to face unknown risks and hazards because few of the guidelines and rules for worker safety are mandatory. In this article, we provide an overview of the current health and safety guidelines for nanotechnology laboratory workers by (...) exploring guidelines from different organizations, including the Department of Energy Nanoscale Science Research Centers, Massachusetts Institute of Technology, the National Institutes of Health, the National Institute for Occupational Safety and Health, the Occupational Safety and Health Administration, Texas A&M University, and University of Massachusetts-Lowell. After discussing these current guidelines, we apply an ethical framework to each set of guidelines to explore any gaps that might exist in them. By conducting this gap analysis, we are able to highlight some of the weaknesses that might be important for future policy development in this area. We conclude by outlining how future guidelines might address some of these gaps, specifically the issue of workers’ participation in the process of establishing safety measures and the development and enforcement of more unified guidelines. (shrink)

In this pathbreaking book, which includes a powerful new translation of Hesiod's Works and Days by esteemed translator David Grene, Stephanie Nelson argues that a society's vision of farming contains deep indications about its view of the human place within nature, and our relationship to the divine. She contends that both Hesiod in the Works and Days and Vergil in the Georgics saw farming in this way, and so wrote their poems not only about farming itself, but also about (...) its deeper ethical and religious implications. Hesiod, Nelson argues, saw farming as revealing that man must live by the sweat of his brow, and that good, for human beings, must always be accompanied by hardship. Within this vision justice, competition, cooperation, and the need for labor take their place alongside the uncertainties of the seasons and even of particular lucky and unlucky days to form a meaningful whole within which human life is an integral part. Vergil, Nelson argues, deliberately modeled his poem upon the Works and Days, and did so in order to reveal that his is a very different vision. Hesiod saw the hardship in farming; Vergil sees its violence as well. Farming is for him both our life within nature, and also our battle against her. Against the background of Hesiods poem, which found a single meaning for human life, Vergil thus creates a split vision and suggests that human beings may be radically alienated from both nature and the divine. Nelson argues that both the Georgics and the Works and Days have been misread because scholars have not seen the importance of the connection between the two poems, and because they have not seen that farming is the true concern of both, farming in its deepest and most profoundly unsettling sense. (shrink)

Subjects have a rich history of decision making which would be expected to affect reasoning in new tasks. For example, averaging, a strategy that is effectively used in many decisions, may help explain the conjunction fallacy. Before resorting to accounts based on phylogeny, more parsimonious accounts in terms of ontogeny should be explored.

For the Sake of the Vedas: The Anglo-German Life of Friedrich Rosen 1805–1837. By Rosane Rocher, with Agnes Stache-Weiske. Abhandlungen für die Kunde des Morgenlandes, vol. 118. Wiesbaden: Harrassowitz, 2020. Pp. xx + 396.

As professionals, nurses are engaged in a moral endeavour, and thus confront many challenges in making the right decision and taking the right action. When nurses cannot do what they think is right, they experience moral distress that leaves a moral residue. This article proposes a theory of moral distress and a research agenda to develop a better understanding of moral distress, how to prevent it, and, when it cannot be prevented, how to manage it.

This study examined the relationship between moral distress intensity, moral distress frequency and the ethical work environment, and explored the relationship of demographic characteristics to moral distress intensity and frequency. A group of 106 nurses from two large medical centers reported moderate levels of moral distress intensity, low levels of moral distress frequency, and a moderately positive ethical work environment. Moral distress intensity and ethical work environment were correlated with moral distress frequency. Age was negatively correlated with moral distress intensity, (...) whereas being African American was related to higher levels of moral distress intensity. The ethical work environment predicted moral distress intensity. These results reveal a difference between moral distress intensity and frequency and the importance of the environment to moral distress intensity. (shrink)

De Marco et al 1 argue that the standard account of medical ‘invasiveness’ (as ‘incision’ or ‘insertion’) fails to capture three aspects of its existing use, namely that invasiveness can come in degrees, often depends on features of alternative medical interventions and can be non-physical. They propose a new schematic account that suggests that medical interventions can possess ‘basic invasiveness’ (which can come in degrees and of which they suggest at least two types: physical and mental), and ‘threshold invasiveness’ which (...) can depend on the alternatives a specific intervention is being compared with. While we agree that the standard account of invasiveness fails to capture existing use and are supportive of their aim, here we express scepticism about the practical utility of De Marco et al ’s revised account. Our scepticism concerns the application of De Marco et al’s revised account in the narrow context of clinician–patient communication and deliberation about medical interventions within clinical practice, which we see as a crucial context for its use. While De Marco et al do not specify the contexts in which their revised account could be used, we assume from their discussion of treatment interventions (e.g. non-invasive prenatal testing, ventilation) and their comparison to ‘more or less invasive’ options, that at least one of the purposes in mind for …. (shrink)

Scientists’ sense of social responsibility is particularly relevant for emerging technologies. Since a regulatory vacuum can sometimes occur in the early stages of these technologies, individual scientists’ social responsibility might be one of the most significant checks on the risks and negative consequences of this scientific research. In this article, we analyze data from a 2011 mail survey of leading U.S. nanoscientists to explore their perceptions the regarding social and ethical responsibilities for their nanotechnology research. Our analyses show that leading (...) U.S. nanoscientists express a moderate level of social responsibility about their research. Yet, they have a strong sense of ethical obligation to protect laboratory workers from unhealthy exposure to nanomaterials. We also find that there are significant differences in scientists’ sense of social and ethical responsibility depending on their demographic characteristics, job affiliation, attention to media content, risk perceptions and benefit perceptions. We conclude with some implications for future research. (shrink)

Argues that positive changes in perspective and deeper spiritual connections to things greater than oneself can influence the world for the better.

Moral duties are regularly attributed to groups. Does this make conceptual sense or is this merely political rhetoric? And what are the implications for these individuals within groups? Collins outlines a Tripartite Model of group duties that can target political demands at the right entities, in the right way and for the right reasons.

Ideomotor theory of human action control proposes that activation of a motor representation can occur either through internally-intended or externally-perceived actions. Critically, sometimes these alternatives of eliciting a motor response may be conflicting, for example, when intending one action and perceiving another, necessitating the recruitment of enhanced action-control to avoid motor mimicry. Based on previous neuroimaging evidence, suggesting that reduced mimicry is associated with self-related processing, we aimed to experimentally enhance these action-control mechanisms during motor contagion by inducing self-focus. In (...) two within-subjects experiments, participants had to enforce their action intention against an external motor contagion tendency under heightened and normal self-focus. During high self-focus participants showed reduced motor mimicry, induced either by mirror self-observation or self-referential judgments. This indicates that a self-focus provoking situation can enhance online action-control mechanisms, needed to resist unintentional motor contagion tendencies and thereby enables a modulation of automatic mirroring responses. (shrink)

Peut-on prédire si un projet sera jugé socialement acceptable par ses principales parties prenantes? Dans un contexte où l’acceptabilité sociale en est venue à être considérée comme une condition à la réalisation de tout grand projet, cette question s’avère centrale pour tout développeur de projet, de même que pour les investisseurs qui les soutiennent. C’est dans cette perspective qu’a été développé l’Indice du risque social dans les projets miniers, une initiative soutenue par l’Autorité des marchés financiers à laquelle a travaillé (...) une équipe interdisciplinaire de chercheurs. Au-delà de jeter un éclairage sur la pertinence d’aller de l’avant ou non avec un projet, cet outil prédictif peut surtout permettre de moduler ledit projet, de concert avec ses parties prenantes, pour le rendre davantage acceptable à leurs yeux. Nous souhaitons ici rendre compte des possibilités offertes par cet indice en l’appliquant à deux projets miniers récemment discutés au Québec, soit le projet de mine aurifère développé par Osisko dans la municipalité de Malartic, en Abitibi-Témiscamingue, et celui de Mine Arnaud, à Sept-Îles, qui vise cette fois l’exploitation de l’apatite. Cet exercice nous permet de réaffirmer la pertinence de l’outil que constitue l’Indice, mais également de relever les limites qui lui sont inhérentes. (shrink)

Compared to evidence-based public health, evidence-based medicine is a more familiar phrase. Evidence-based medicine has become increasingly popular in the past decade, due in large part to the emergence of computerized database search technology and advanced statistical tools which allow researchers to quickly identify and summarize vast amounts of scientific information.Today, the concept of evidence-based public health is gaining momentum and has grown in popularity. However, the term “evidence-based” lacks clarification and is subject to a variety of interpretations. The evidence (...) that supports evidence-based medicine or public health may include individual experience, anecdotal information, the content of a single scientific article, or the results of a sophisticated systematic review of scientific literature. The imprecise language used to describe evidence leads to confusion over what types of evidence are most appropriate in answering different types of questions. (shrink)

Compared to evidence-based public health, evidence-based medicine is a more familiar phrase. Evidence-based medicine has become increasingly popular in the past decade, due in large part to the emergence of computerized database search technology and advanced statistical tools which allow researchers to quickly identify and summarize vast amounts of scientific information.Today, the concept of evidence-based public health is gaining momentum and has grown in popularity. However, the term “evidence-based” lacks clarification and is subject to a variety of interpretations. The evidence (...) that supports evidence-based medicine or public health may include individual experience, anecdotal information, the content of a single scientific article, or the results of a sophisticated systematic review of scientific literature. The imprecise language used to describe evidence leads to confusion over what types of evidence are most appropriate in answering different types of questions. (shrink)

Many meta-ethicists are alethists: they claim that practical considerations can constitute normative reasons for action, but not for belief. But the alethist owes us an account of the relevant difference between action and belief, which thereby explains this normative difference. Here, I argue that two salient strategies for discharging this burden fail. According to the first strategy, the relevant difference between action and belief is that truth is the constitutive standard of correctness for belief, but not for action, while according (...) to the second strategy, it is that practical considerations can constitute motivating reasons for action, but not for belief. But the former claim only shifts the alethist's explanatory burden, and the latter claim is wrong—we can believe for practical reasons. Until the alethist can offer a better account, then, I argue that we should accept that there are practical reasons for belief. (shrink)

Popper: I do admit that at any moment we are prisoners caught in the framework of our theories; our expectations; our past experiences; our language. But we are prisoners in a Pickwickian sense: if we try, we can break out of our framework at any time. Admittedly, we shall find ourselves again in a framework, but it will be a better and roomier one; and we can at any moment break out of it again.Kuhn: If that possibility were routinely available, (...) there ought to be no very special difficulties about stepping into someone else's framework in order to evaluate it. My critics' attempts to step into mine suggest, however, that changes of framework, of theory, of language, or of paradigm pose deeper problems of both .. (shrink)

Throughout the Covid-19 pandemic, people have been eager to learn what factors, and especially what public health policies, cause infection rates to wax and wane. But figuring out conclusively what causes what is difficult in complex systems with nonlinear dynamics, such as pandemics. We review some of the challenges that scientists have faced in answering quantitative causal questions during the Covid-19 pandemic, and suggest that these challenges are a reason to augment the moral dimension of conversations about causal inference. We (...) take a lesson from Martha Nussbaum—who cautions us not to think we have just one question on our hands when we have at least two—and apply it to modeling for causal inference in the context of cost-benefit analysis. (shrink)

With the growth of precision medicine research on health data and biospecimens, research institutions will need to build and maintain long-term, trusting relationships with patient-participants. While trust is important for all research relationships, the longitudinal nature of precision medicine research raises particular challenges for facilitating trust when the specifics of future studies are unknown. Based on focus groups with racially and ethnically diverse patients, we describe several factors that influence patient trust and potential institutional approaches to building trustworthiness. Drawing on (...) these findings, we suggest several considerations for research institutions seeking to cultivate long-term, trusting relationships with patients: Address the role of history and experience on trust, engage concerns about potential group harm, address cultural values and communication barriers, and integrate patient values and expectations into oversight and governance structures. (shrink)

The Corporate Social Performance (CSP) model (Wood, Acad Manag Rev 164:691–718, 1991) assesses a firm’s social responsibility at three levels of analysis—institutional, organizational and individual—and measures the resulting social outcomes. In this paper, we focus on the individual level of CSP, manifested in the managerial discretion of a firm’s principles, processes, and policies regarding social responsibilities. Specifically, we address the human resources management of employees as a way of promoting CSR values and producing socially minded outcomes. We show that applying (...) the humanist philosophy to the managerial discretion of a business organization leads to the creation of an “autonomy supportive work environment”—as defined by the self-determination theory—which in turn, facilitates the internalization of social values, citizenship behaviors, and cooperation. The objective of promoting self-determination at work (i.e., the core of a humanist management) fits well with the ontology of social responsibility since autonomy and consideration of individuals as moral actors are central tenets. Furthermore, we show that applying humanistic management philosophy to the discretion of managers can lead to socially responsible outcomes. First, intra-organizational stakeholders (e.g., employees) are treated with respect and focus is put on their well-being, satisfaction, and self-actualization at work. Second, as employees’ need of self-determination is addressed by managers, it is likely that pro-social behaviors toward other stakeholders of the organization will be adopted, leading to socially responsible outcomes for extra-organizational stakeholders (Gagné, Motiv Emot 77:58–75, 2003). Thus, this paper ultimately posits that humanistic management applied to the HRM can be a solution for developing and maintaining socially responsible outcomes as determined at the individual level of the CSP model, through managerial discretion. (shrink)

Classic statements of research ethics advise against permitting physician-investigators to obtain consent for research participation from patients with whom they have preexisting treatment relationships. Reluctance about “dual-role” consent reflects the view that distinct normative commitments govern physician–patient and investigator–participant relationships, and that blurring the research–care boundary could lead to ethical transgressions. However, several features of contemporary research demand reconsideration of the ethics of dual-role consent. Here, we examine three arguments advanced against dual-role consent: that it creates role conflict for the (...) physician-investigator; that it can compromise the voluntariness of the patient-participant’s consent; and that it promotes therapeutic misconceptions. Although these concerns have merit in some circumstances, they are not dispositive in all cases. Rather, their force—and the ethical acceptability of dual-role consent—varies with features of the particular study. As research participation more closely approximates usual care, it becomes increasingly acceptable, or even preferable, for physicians to seek consent for research from their own patients. It is time for a more nuanced approach to dual-role consent. (shrink)

Plausibly, only moral agents can bear action-demanding duties. This places constraints on which groups can bear action-demanding duties: only groups with sufficient structure—call them ‘collectives’—have the necessary agency. Moreover, if duties imply ability then moral agents (of both the individual and collectives varieties) can bear duties only over actions they are able to perform. It is thus doubtful that individual agents can bear duties to perform actions that only a collective could perform. This appears to leave us at a loss (...) when assigning duties in circumstances where only a collective could perform some morally desirable action and no collective exists. But, I argue, we are not at a loss. This article outlines a new way of assigning duties over collective acts when there is no collective. Specifically, we should assign collectivisation duties to individuals. These are individual duties to take steps towards forming a collective, which then incurs a duty over the action. I give criteria for when individuals have collectivisation duties and discuss the demands these duties place on their bearers. (shrink)

Noninvasive, prenatal whole genome sequencing may be a technological reality in the near future, making available a vast array of genetic information early in pregnancy at no risk to the fetus or mother. Many worry that the timing, safety, and ease of the test will lead to informational overload and reproductive consumerism. The prevailing response among commentators has been to restrict conditions eligible for testing based on medical severity, which imposes disputed value judgments and devalues those living with eligible conditions. (...) To avoid these difficulties, we propose an unrestricted testing policy, under which prospective parents could obtain information on any variant of known significance after a careful informed consent process that uses an interactive decision aid to deliver a mandatory presentation on the purposes, techniques, and limitations of genomic testing, as well as optional resources for reflection and consultation. This process would encourage thoughtful, informed deliberation... (shrink)

Digital phenotyping will potentially enable earlier detection and prediction of mental illness by monitoring human interaction with and through digital devices. Notwithstanding its promises, it is certain that a person’s digital phenotype will at times be at odds with their first-person testimony of their psychological states. In this paper, we argue that there are features of digital phenotyping in the context of psychiatry which have the potential to exacerbate the tendency to dismiss patients’ testimony and treatment preferences, which can be (...) instances of epistemic injustice. We first explain what epistemic injustice is, and why it is argued to be an extensive problem in health and disability settings. We then explain why epistemic injustice is more likely to apply with even greater force in psychiatric contexts, and especially where digital phenotyping may be involved. Finally, we offer some tentative suggestions of how epistemic injustice can be minimised in digital psychiatry. (shrink)

There is disagreement in the literature about the exact nature of the phenomenon of empathy. There are emotional, cognitive, and conditioning views, applying in varying degrees across species. An adequate description of the ultimate and proximate mechanism can integrate these views. Proximately, the perception of an object's state activates the subject's corresponding representations, which in turn activate somatic and autonomic responses. This mechanism supports basic behaviors that are crucial for the reproductive success of animals living in groups. The Perception-Action Model, (...) together with an understanding of how representations change with experience, can explain the major empirical effects in the literature. It can also predict a variety of empathy disorders. The interaction between the PAM and prefrontal functioning can also explain different levels of empathy across species and age groups. This view can advance our evolutionary understanding of empathy beyond inclusive fitness and reciprocal altruism and can explain different levels of empathy across individuals, species, stages of development, and situations. Key Words: altruism; cognitive empathy ; comparative; emotion; emotional contagion; empathy ; evolution; human; perception-action; perspective taking. (shrink)

This essay briefly introduces and contextualizes the extant work on aesthetic snobbery, and identifies some areas for further inquiry. Currently four kinds of snobbery have been identified—social contagion snobbery, attitudinal snobbery, contextual snobbery, and straight-up classist snobbery. Interestingly, each kind of snobbery is thought to manifest itself as a distinct epistemic failing, and for this reason they are advanced as distinct, non-competing kinds of snobbery. Some snob’s aesthetic judgments will be false or unjustified (social-contagion and straight-up classist), some will be (...) unfitting (contextual), and some will fail to have an apt attitude toward their aesthetic judgment (attitudinal). Because the debate has been framed so narrowly, on how the vice of aesthetic snobbery undermines aesthetic judgment, several fruitful areas of philosophical investigation remain unexplored. (shrink)

Growing interest in embedded research approaches—where research is incorporated into clinical care—has spurred numerous studies to generate knowledge relevant to the real-world needs of patients and other stakeholders. However, it also has presented ethical challenges. An emerging challenge is how to understand the nature and extent of investigators’ obligations to patient-subjects. Prior scholarship on investigator duties has generally been grounded upon the premise that research and clinical care are distinct activities, bearing distinct duties. Yet this premise—and its corresponding implications—are challenged (...) when research and clinical care are deliberately integrated. After presenting three case studies from recent pragmatic clinical trials, we identify six differences between explanatory trials and embedded research that limit the application of existing scholarship for ascertaining investigator duties. We suggest that these limitations indicate a need to account for the implications of usual care and to move beyond a narrow focus on the investigator-subject dyad, one that better reflects the team- and institution-based nature of contemporary health systems. (shrink)

A memoir of one womanÆs struggle against breast cancer reveals how she channeled her energy to transform her life, even as she was dying.

In a recent and provocative essay, Christopher Bartel attempts to resolve the gamer’s dilemma. The dilemma, formulated by Morgan Luck, goes as follows: there is no principled distinction between virtual murder and virtual pedophilia. So, we’ll have to give up either our intuition that virtual murder is morally permissible—seemingly leaving us over-moralizing our gameplay—or our intuition that acts of virtual pedophilia are morally troubling—seemingly leaving us under-moralizing our game play. Bartel’s attempted resolution relies on establishing the following three theses: (1) (...) virtual pedophilia is child pornography, (2) the consumption of child pornography is morally wrong, and (3) virtual murder is not murder. Relying on Michael Rea’s definition of pornography, I argue that we should reject thesis one, but since Bartel’s moral argument in thesis two does not actually rely thesis one that his resolution is not thereby undermined. Still, even if we grant that there are adequate resources internal to Bartel’s account to technically resolve the gamer’s dilemma his reasoning is still unsatisfying. This is so because Bartel follows Neil Levy in arguing that virtual pedophilia is wrong because it harms women. While I grant Levy’s account, I argue that this is the wrong kind of reason to resolve the gamer’s dilemma because it is indirect. What we want is to know what is wrong with virtual child pornography itself. Finally, I suggest alternate moral resources for resolving the gamer’s dilemma that are direct in a way that Bartel’s resources are not. (shrink)

This chapter argues that the best way for a non-naturalist to explain why the normative supervenes on the natural is to claim that, while there are some sui generis normative properties whose essences cannot be fully specified in non-normative terms and do not specify any non-normative sufficient conditions for their instantiation, there are certain hybrid normative properties whose essences specify both naturalistic sufficient conditions for their own instantiation and sufficient conditions for the instantiation of certain sui generis normative properties. This (...) is the only metaphysical explanation for supervenience on offer, the chapter argues, that can both clearly maintain the pre-theoretical commitments of non-naturalism, and provide a metaphysical explanation not just for supervenience, but for all metaphysical necessities involving natural and normative properties. (shrink)

The ethics of care has flourished in recent decades yet we remain without a succinct statement of its core theoretical commitment. This book uses the methods of analytic philosophy to argue for a simple care ethical slogan: dependency relationships generate responsibilities. It uses this slogan to unify, specify and justify the wide range of views found within the care ethical literature.

In this paper, I consider a particular amoralist challenge against those who would morally criticize our single-player video play, viz., “come on, it’s only a game!” The amoralist challenge with which I engage gains strength from two facts: the activities to which the amoralist lays claim are only those that do not involve interactions with other rational or sentient creatures, and the amoralist concedes that there may be extrinsic, consequentialist considerations that support legitimate moral criticisms. I argue that the amoralist (...) is mistaken and that there are non-consequentialist resources for morally evaluating our single-player game play. On my view, some video games contain details that anyone who has a proper understanding of and is properly sensitive to features of a shared moral reality will see as having an incorrigible social meaning that targets groups of individuals, e.g., women and minorities. I offer arguments to support the claim that there are such incorrigible social meanings and that they constrain the imaginative world so that challenges like “it’s only a game” lose their credibility. I also argue that our responses to such meanings bear on evaluations of our character, and in light of this fact video game designers have a duty to understand and work against the meanings of such imagery. (shrink)